Longer looks: A jack-of-all-trades surgeon takes care of Nantucket; Psychiatrist's controversial effort to use brain scans to diagnose mental problems

Aug 17 2012

Every week Shefali S. Kulkarni selects interesting reading from around the Web.

WBUR: Nantucket Doctor's Experience Gives Insight Into National Health Care
Dr. Tim Lepore, 67, is a jack-of-all-trades general surgeon, tending to the 10,000 full-time residents of the Massachusetts island of Nantucket and to the many thousand more rich and famous summer-dwellers. Dr. Lepore has dealt with everything from poison ivy and tick-borne illnesses to narcolepsy and toe tourniquet syndrome (when a mother's hair wraps around a baby's toe, cutting off circulation). He counsels alcoholics, and allows patients to barter for health care. He once accepted oatmeal cookies from an immigrant worker who had no money for treatment. ... (Pam) Belluck tells Lepore's story in the book, "Island Practice: Cobblestone Rash, Underground Tom, and Other Adventures of a Nantucket Doctor," and she says that the care he provides to patients is relevant to the national debate about health care. "I think policy makers and politicians should keep in mind that at bottom what people want is a doctor who is going to be devoted to them and be able to spend time with them" (Robin Young, Tim Lepore and Pam Belluck, 8/13).

The Washington Post Magazine: Daniel Amen Is The Most Popular Psychiatrist In America. To Most Researchers And Scientists, That's A Very Bad Thing
Daniel Amen is, by almost any measure, the most popular psychiatrist in America. ... Patients adore him. ... He has arisen, like a modern-day American myth, from the fields northeast of San Francisco, where he ran a small-town clinic, to become the creator, chairman and CEO of the Amen Clinics, an empire that includes a string of psychiatric practices, a line of nutritional supplements, book publishing, DVD sales, and television and speaking engagements. He says his businesses, including four clinics -; three on the West Coast and one in Reston -; employ 100 people, among them 16 psychiatrists, and grossed about $20 million last year. ... (Amen asserts) that he has harnessed a type of brain imaging to transform psychiatric practice itself (Neely Tucker, 8/9).

The New York Times: War Wounds
(Maj. Ben) Richards's finest hour, and in retrospect his worst, came in Iraq in 2007. ... [O]ne day a car bomb destroyed his Stryker vehicle, giving Richards a severe concussion that left him nauseated and dazed for a week. Three weeks later, a roadside bomb knocked him out again, and he suffered a second concussion, with similar results. Richards, now 36, struggled for months with headaches, fatigue, insomnia and fainting spells; once he passed out in the middle of a firefight. Still, he didn't seek medical care. He figured he wasn't really injured, and that has been a widespread problem: the military value system is such that warriors disdain medical care as long as they are physically capable of fighting. "Coming from an Army ethos," he says wryly, "you're not even entitled to complain unless you've lost all four limbs." Yet there's growing evidence that concussions -; whether in sports or in the military -; are every bit as damaging as far bloodier wounds. When someone suffers blows to the head, the result can be a traumatic brain injury, or T.B.I. This, eventually, was Richards's diagnosis (Nicholas D. Kristof, 8/10).

The New York Times: In Ill Doctor, A Surprise Reflection Of Who Picks Assisted Suicide
Dr. Richard Wesley has amyotrophic lateral sclerosis, the incurable disease that lays waste to muscles while leaving the mind intact. He lives with the knowledge that an untimely death is chasing him down, but takes solace in knowing that he can decide exactly when, where and how he will die. Under Washington State's Death With Dignity Act, his physician has given him a prescription for a lethal dose of barbiturates. He would prefer to die naturally, but if dying becomes protracted and difficult, he plans to take the drugs and die peacefully within minutes. ... Dr. Wesley is emblematic of those who have taken advantage of the law. They are overwhelmingly white, well educated and financially comfortable. And they are making the choice not because they are in pain but because they want to have the same control over their deaths that they have had over their lives (Katie Hafner, 8/11).